Many Children Struggling After '05 Storms

New York Times
By LESLIE EATON
December 7, 2007
At least 46,600 children along the Gulf Coast are still struggling with mental health problems and other serious aftereffects of 2005 hurricanes, according to a new study by the Mailman School of Public Health at Columbia University and the Children’s Health Fund.

Many of these children are performing poorly in school and have limited access to medical care, according to the study, which combines government statistics with data collected by a group of researchers that has been closely following about 1,250 families displaced by the storm.

The children most at risk are those who have returned to their home states of Louisiana and Mississippi but lack stable living situations, the study says.

They are children like Nicole D. Riley’s daughter Isis, who is about to turn 4. Her family left New Orleans the day before Hurricane Katrina and moved five times over a short period before ending up in the large government-operated trailer park in Baker, La. All those moves “really didn’t sit well with her,” Ms. Riley said of her daughter. “When we got out here to the park, she was out of control, out of hand. She was not like that before the storm.”

Although the uncontrollable temper tantrums have stopped, Ms. Riley said in a telephone interview, Isis remains worrisomely moody, and all three of her children have been suffering from rashes. And they are going to have to move again. The government plans to close the trailer park next spring, and Ms. Riley and her fiancé are already looking for a new place to live.

Doctors treating Isis and other children “have been reporting just tremendous problems, especially the mental health providers,” said Dr. Irwin Redlener, president of the Children’s Health Fund and director of the National Center for Disaster Preparedness at Columbia. “We are alarmed at the continuing downward trend, the longer the state of limbo continues.”

Moving beyond anecdotal evidence is difficult, but the study tries to quantify the number of children who remain at risk. “It’s meant to answer the question, what is the magnitude of the problem here,” said David Abramson, the center’s research director.

Looking at federal census data, school enrollment statistics and figures from the Federal Emergency Management Agency, the study concludes that about 163,000 children were displaced by the storms and that 81,000 to 95,000 have returned to Louisiana and Mississippi. An estimated 11,200 children were still living in FEMA trailers at government or private trailer parks at the end of September, according to the report, though that number has been dropping as the government begins closing the parks.

To determine how many of the returned children are likely to be experiencing problems, the researchers extrapolated from the findings of their continuing study of Gulf Coast families, which has found almost a third of the children examined have developed depression, anxiety or behavior disorders since the hurricanes.

In Louisiana, parents of about a quarter of the children reported that performance at school has slipped sharply since the storms; that has not been as much of an issue in Mississippi, where a bigger problem has been the loss of doctors or health insurance. While poor families fared far worse than wealthier ones in Louisiana, in Mississippi the results were similar for families with incomes of less than $10,000 and those with incomes of over $35,000.

Over all, the report concludes that 46,600 to 64,900 children are experiencing serious poststorm problems, though Dr. Redlener said he puts the number at about 55,000.

Roberta Avila, executive director of the Mississippi Coast Interfaith Disaster Task Force, said that figure sounds right. “We still have a lot of families in trailers, and the stress of living in that situation is really tough,” she said. Despite strong community and volunteer efforts, she continued, she is hearing increasing reports of problems ranging from children having trouble doing homework all the way up to suicides.

In New Orleans, one of the biggest problems for children is that their extended families are no longer nearby, said David J. Ward, a health policy analyst and founder of the Louisiana Health Services Recovery Council. “The fabric of the family has splintered,” Mr. Ward said. “Who is going to take care of the kids after school, or draw them into becoming musicians?”

New York Times
By BENEDICT CAREY
December 4, 2007
The first study to rigorously assess the mental health fallout from Hurricane Katrina has confirmed what many researchers and Gulf Coast residents predicted: that mood problems after the storm occurred about as often as in any natural disaster ever studied, and that the delayed government response almost certainly made the problem worse.

The analysis, a continuing survey of more than 1,000 residents of New Orleans and surrounding areas, found that 17 percent of people in the city reported signs of serious mental illness in the month after the disaster, compared with 10 percent in surrounding areas. The estimated prevalence of such problems in the general population is 1 to 3 percent in any month.

Post-traumatic stress symptoms — which include flashbacks, nightmares, a hair-trigger temper — were by far the most common type of mental problem and were often associated with incidents that happened in the storm’s wake, like property losses, robberies and assaults.

Nearly half of New Orleans residents in the survey reported some significant symptoms of anxiety in that first month after the storm, about as high as can be expected in a community hit by a natural disaster, according to the study, being published today in the Archives of General Psychiatry. Women, young adults and lower-income residents were hardest hit, just as studies of previous disasters have found.

Experts said the study was crucial to understanding where to direct resources after such catastrophes.

The study was a joint project, financed by the National Institute of Mental Health and including researchers from seven universities. The investigators recruited 1,043 adults from New Orleans and surrounding areas that were directly affected by the hurricane. From January to March 2006, about six months after the hurricane, the surveyors asked participants 30 questions, including one open-ended query: “What would you say are currently your most serious practical problems caused by Katrina?”

Based on the answers, the researchers focused on 10 common storm-related incidents, like risk of death in the storm or an assault on a loved one in the lawless limbo before some order was restored. They found that property loss affected 70 percent of New Orleans respondents and that 40 percent of the city dwellers reported other traumas, like robberies, compared with 17 percent living outside the city.

Over all, New Orleans residents were nearly twice as likely as those living elsewhere to report mild or serious mental distress. The authors said they expected many of these post-traumatic effects to resolve with time; depending on how horrifying their experience, 3 to 10 percent of people will suffer symptoms for a year or longer.

“The main message here is that the primary drivers of mental health risk were social and financial circumstances,” said Dr. Sandro Galea, an associate professor at the University of Michigan and the study’s lead author. “So if we’re intent on minimizing psychopathology, it means mitigating those stressors quickly” by restoring order and helping people back on their feet financially.